Application of the UPOINT classification to determine indications for antibacterial therapy of chronic inflammatory process

Abstract

Background. Patients with chronic prostatitis (CP) represent the majority of urological referral. The most patients, independent of their age, visit attending urologists constantly. Aim. To evaluate the rate of antibiotics prescriptions based on the UPOINTS chronic prostatitis classification and the estimation of its efficacy. Materials and methods. In 2022–2023 there were enrolled 92 CP patients in the Pletnev City Clinical Hospital and Vishnevsky National Medical Research Center for High Medical Technologies – Central Military Clinical Hospital. The age varies from 22 to 46 year (mean 34±8). The diagnosis lifespan was – 11+16.5 mo. The NIH-CPSI score was 23±6.1 (pain 8±5.5, urination – 7±2.4, life quality 8±3.6). The prostate volume was 26±8 cc. The positive Meares-Stamey test was occurred in 38/92 (41%) cases. The positive prostate or sperm culture were found in 18/92 (20%) pts. The positive PCR-tests were obtained in 32/42 (76%) urethral samples, prostate secretes 23/42 (55%) and sperm – 20/42 (48%). Fluorochinilones were prescribed in all 92 (100%) cases, tetracycline (66 patients, 72%) and macrolides – 48 patients, 52%. Results. Sixty eight (74%) pts have passed the follow-up. The total NIH-CSPI score decreased to 15±5.3 (pain – 6±3.6, urination – 5±2.1, life quality 4±2). The average prostate volume was 23±4 cc, at 86% (58) cases were achieved the laboratory tests normalization. The fluorchinolones efficacy was – 29% (17 patients), tetracycline – 41% (24 patients), macrolides – 29% (17 patients). Conclusion. The UPOINT classification use allows optimize the CP management. PCR-tets are the most sensitive in terms of the I-type CP diagnosis. The administration of Doxycycline Express® in the I-type of CP treatment is the most effective (41%) in the comparison to the other antibiotics.